Growth-differentiation factor-15 in heart failure

The stress-responsive transforming growth factor-beta-related cytokine, growth-differentiation factor-15 (GDF-15), is emerging as a new biomarker in patients with cardiovascular disease.

The circulating levels of GDF-15 are elevated and independently related to an adverse prognosis in acute coronary syndrome and left- or right-sided heart failure. GDF-15 adds significant prognostic information to established clinical and biochemical risk markers in these conditions.

Elevated levels of GDF-15 may identify patients who have non-ST-elevation acute coronary syndrome who derive the greatest benefit from an invasive treatment strategy. As with other heart failure biomarkers, including BNP, it is currently not known what specific therapies could be used to reduce the risk associated with elevated levels of GDF-15 in heart failure.

Further elucidation of the pathobiology and upstream inducers of this new biomarker may lead to new therapeutic concepts that address the risk associated with elevated GDF-15 levels. A commercial assay for GDF-15 should be available in the near future.


Growth-differentiation factor-15 in heart failure
Kempf T, Wollert KC
Heart Fail Clin. 2009 Oct ; 5(4): 537-47 (Hubmed.org)



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Biomarkers of oxidative stress in heart failure

Oxidative stress is the relative excess of reactive oxygen species (ROS) versus endogenous defense mechanisms. Abundant evidence has demonstrated the role of ROS, along with reactive nitrogen species (RNS), in the pathophysiology of cardiovascular disease, including heart failure.

Many biomarkers of oxidative stress have been studied as surrogates of oxidative damage. Recently, markers of impaired nitric oxide signaling have also been identified. Many biomarkers have been associated with prognosis and mortality, and some may even be modified by therapy.

However, the clinical utility is limited by less than optimal standardization techniques and the lack of sufficient large-sized, multimarker prospective trials


"Biomarkers of oxidative stress in heart failure"
Trachtenberg BH, Hare JM
Heart Fail Clin. 2009 Oct ; 5(4): 561-77



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